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目的探讨一例狂犬病例疫苗免疫失败原因以及病例确诊方法。方法对病例进行详细的流行病学调查,采集相关组织标本进行狂犬病抗原及核酸检测。结果病例伤口暴露后及时在医疗机构进行了伤口处理,并注射狂犬病疫苗5针后死亡,检测病例海马、脑干、小脑、白质、灰质、脊髓的组织狂犬病抗原阳性和狂犬病毒核酸阳性,而角膜、背皮、咬伤处皮肤狂犬病抗原和狂犬病毒核酸均为阴性。结论该病例属于注射狂犬疫苗后免疫失败,可能与疫苗质量、免疫程序及注射针次有一定的关系。及时采集病例脑组织进行狂犬病抗原及核酸检测可作为病例确诊依据。
Objective To investigate a case of vaccine immunization failure rabies cases and cases confirmed. Methods A detailed epidemiological investigation was carried out on the cases, and relevant tissue samples were collected for rabies antigen and nucleic acid detection. Results The wounds of the wounds were treated in the medical institutions immediately after the wounds were exposed. Rabbits were killed after 5 doses of the rabies vaccine. The tissues of the hippocampus, brainstem, cerebellum, white matter, gray matter and spinal cord were positive for rabies antigen and positive for rabies virus. , Dorsal skin, biting skin rabies antigen and rabies virus nucleic acid were negative. Conclusion This case belongs to immunization failure after injection of rabies vaccine, which may be related to vaccine quality, immunization procedure and injection needle. Timely collection of cases of brain tissue rabies antigen and nucleic acid detection can be used as the basis for diagnosis.